Is Personal Recovery in Schizophrenia Predicted by Low Cognitive Insight?

Just like other mental illnesses recovery from schizophrenia is widely discussed and this made the baseline for this study with focus on assessing the relationship between personal recovery and prediction variables.  Particularly, the study focused on critical recovery variables such as psychopathology, neurocognition, clinical and cognitive insight, and social functioning among patients suffering from schizophrenia.

During the study, a total of 76 participants were assessed, with the inclusion criteria being inpatients suffering from schizophrenia during their hospital discharge. The study design entailed participants who have been consecutively affected by schizophrenia spread over five months based on diagnosis by a trained interviewer using DSM-IV-R SCID. In measuring the severity of psychopathology, the researchers used the Brief Psychiatric Rating Scale-24, BPRS, the Positive And Negative Syndrome Scale, PANSS as well as the Personal and Social Performance scale, PSP in assessing the subjects’ social functioning.

In realizing the study objectives, the findings were statistically analyzed in four phases: summary, colleration, multiple test adjustment and multiple regression analysis. The subjects’ gender and place of living notwithstanding, all the subjects were taking new-generation antipsychotics at the time if analysis. The study findings indicated that there exist a significant positive correlation between age and years of illness, while psychopathological measures, BPRS and PANSS total scores, showing that the older subjects with a long history of illness suffered a more severe psychopathology. It was also found that psychopathology greatly impacts on social functioning, evidenced by a general negative correlation between PANSS total score and PSP.

However, there was strong correlation between NCOG and social functioning, while a good level of neurocognitive performance was associated with good social and meta-cognitive function, with a similar positive correlation with clinical insight measures. This finding suggests that a good level of cognitive functioning helps the subject affected by schizophrenia to be fully aware of the present and the past episodes of illness. Negative correlation between cognitive insight and self-reflectiveness and its positive association with severity of psychopathology confirm that a person’s perception of recovery has lower effect on social functioning and general recovery.

The fact that low self-reflectiveness of the cognitive insight was found as the main predictive variable towards personal recovery did not confirm the study hypothesis that persons with schizophrenia who have better metacognitive capacity also have a stronger subjective experience of recovery. Thus, the study findings confirm that self-reflection is negatively associated with well being. This makes it necessary to develop tailored interventions that can assist people in situations that are affecting them and useful to challenge their illness, with a determination to ensure that the efforts demonstrate enhanced gains to schizophrenic patients that are different from traditional, clinic-based cognitive and psychosocial rehabilitation efforts.

You have just read a summary of the research paper: Giusti, Laura, et al. “Is Personal Recovery in Schizophrenia Predicted by Low Cognitive Insight?” Community mental health journal (2014): 1-8.